HIV/AIDS in Sudan

Stemming the spread of HIV/AIDS in Sudan

by Shannon Egan

International and Sudanese organisations working to prevent the spread of HIV/AIDS fear an increase in infection rates as a result of large return movements of refugees and IDPs.

With 1.5 million IDPs expected to return home by the end of 2006 and the imminent return of refugees from neighbouring countries whose rates of HIV/AIDS prevalence greatly exceed Sudan’s estimated 2.6%, the impact of the pandemic could spread.

Abu Bakr A Waziri, HIV/AIDS project manager of UNFPA warns that “…the situation will be very grim if the necessary measures are not taken from now, as the returnees coming from these infected areas will intermingle with the people in their new area.”

The head of UNHCR’s HIV/AIDS programme, Paul Spiegel, acknowledges the potential risks of an increase in HIV infections but urges people not to jump to conclusions with regard to HIV prevalence among returnees. “While it is true that conflict-affected populations and refugees are at greater risk of HIV infection – because of sexual violence and disruption of health services – this doesn’t necessarily translate into higher infection rates,” Spiegel said. “Actual infection rates are highly context specific.” Key factors include the HIV prevalence in the area of origin, infection rates of the population surrounding refugee camps and the time refugees have spent in the camp. In addition, the increased risk of HIV infection in a time of conflict could be offset by a decreased risk as refugees’ mobility is reduced and their level of HIV/AIDS awareness raised through educational programmes in refugee camps.[1]

Rather than perceiving the return of Sudanese refugees as a potential risk for increased HIV infections in southern Sudan, Spiegel prefers to see the return of refugees as an opportunity. Those who have been educated in camps about HIV/AIDS and who have been trained as health workers or nurses can in turn educate and assist the communities with which and to which they will return.

Response

Government institutions have become increasingly aware of the situation and have initiated HIV/AIDS prevention programmes throughout the country. Education authorities have introduced teaching about the risks of unprotected sex in both primary and secondary school curricula. The Ministry of Religion is encouraging Muslim and Christian communities to discuss preventive measures. Military authorites are instructing soldiers in the use of condoms.

In 2003 President Omar al-Bashir shook hands with HIV/AIDS-infected people in front of an audience of over 1,000 Sudanese citizens in order to spread the message that those living with HIV/AIDS would be supported by the nation. During this assembly, the president also made a commitment to support and fund projects dedicated to eradicating the spread of HIV/AIDS.

UNAIDS, UNFPA and UNHCR have made a commitment to support, fund and collaborate with one another’s HIV/AIDS-related projects. These focus on motivating community leaders to speak out in public about HIV/AIDS issues, enabling more people to access treatment, educating displaced people in camps and rural areas so that they can in turn educate their communities once they return home, and involving Sudanese people living with HIV/AIDS in informing, educating and counselling others.

HIV/AIDS-infected people join the fight

The Sudanese People Living with HIV/AIDS Care Association (SPLWHACA) was established in 2003 in Khartoum by local HIV/AIDS-infected persons to provide support to the more than 600,000 people with HIV/AIDS in Sudan. The organisation provides counselling to help people to live a normal life and to play a key role in educating their communities about methods of HIV/AIDS contraction and prevention as well as in fighting the stigma surrounding the disease. According to Joseph Jenoro Ochilla, SPLWHACA’s head, “The purpose of the counselling is, yes, to provide support but also to instil confidence in the HIV/AIDS-infected person so that they can go out into the community and make people aware of the issue by saying, ‘I am HIV positive and that is okay.’”

The 250 members of the SPLWHACA work around the clock on a voluntary basis to provide support and to educate communities in seven of Sudan’s 18 states. Their work is beset by obstacles. Due to lack of funding, they have no office. When they try to educate Sudanese about HIV/AIDS, they are often ridiculed, even thrown out by communities, largely due to the correlation of HIV/AIDS transmission with sexual intercourse outside of marriage, an act condemned by the country’s Islamic sharia law. As Ochilla explains, “The people in Sudan want to keep those who are positive in a fenced area so as not to disturb the community. But they don’t understand that those of us who are aware that we are positive are less dangerous than those who are positive but do not know they are positive.”

Asha Ebrahim, SPLWHACA information counsellor, became involved with the network when she learnt that she was HIV positive as a result of a blood transfusion. The most difficult thing about living with HIV/AIDS in Sudan, she says, is the harsh treatment by her peers due to the stigma surrounding the disease. “As soon as the man who owns the house I am renting learns that I am positive, I am kicked out. Teachers in the school tell my children that there is no place for them.” Despite these difficulties, Asha is dedicated to informing and educating the people of Sudan about HIV/AIDS. She has appeared on numerous television programmes and has become a key speaker in many HIV/AIDS-related workshops throughout Sudan.

For Ochilla, the reward of working with SPLWHACA is in seeing those infected with HIV/AIDS begin to believe in a happier future and in watching communities gradually open up to the messages spread by SPLWHACA members. “In the end it is not easy but we are dedicated to the work because we believe that it is important and that in time we can make a difference in the spread of HIV/AIDS in Sudan.”

Shannon Egan is a freelance journalist in Sudan. Email: shannonegan1@yahoo.com Among others, she writes for IRIN www.IRINnews.org